Browsing by Author "Shrestha, Smita"
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Publication Advance Age Pregnancy in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Mahato, Vibha; Shrestha, Pravin; Shrestha, SmitaAbstract: Introduction: Women who conceive at advance age are at risk of pregnancy complications and adverse foetal outcome. This study aims to find out the prevalence of pregnancy at advance age in a teaching hospital. Methods: A descriptive cross-sectional study was conducted between October 2019 to August 2020 at department of obstetrics and gynaecology of a tertiary care centre of Nepal, after obtaining ethical clearance from Institutional Review Committee (dated 03/09/2019 with ref no. 266) and informed consent from patient. Convenience sampling was done. All the patient who were ≥35 years and >28 weeks of gestation without any chronic illness were selected. Data and descriptive analysis were done using Statistical Package for the Social Sciences version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Women aged 35 years and above constituted 104 (5.73%) of the total deliveries of study period. Most were multigravida 72 (69.23%) and 23 (22.12%) had preterm delivery. Rate of caesarean section were higher in advance maternal age 69 (66.35%). Maternal complications such as Hypertensive disorder of pregnancy 9 (8.65%), and mal-presentation 15 (14.42%) were higher among them. Perinatal outcome in form of low birth weight 9 (8.65%) and perinatal death 5 (4.80%) were increased in those women. Conclusions: From this study, it can be concluded that prevalence of advanced age at pregnancy was lower than study done in developed country but it was similar to study in India and is increasing in Nepal.Publication Clinical characteristics and visual outcome of Vogt Koyanagi Harada disease patients in a specialized eye hospital in Nepal(Nepal Health Research Council, 2025) Paudel, Jyoti Bastola; Manandhar, Anu; Shrestha, SmitaBackground: To evaluate clinical characteristics and visual outcome of Vogt-Koyanagi-Harada disease patients in Nepal. Methods: Retrospective series of all the cases of VKH treated at Tilganga Institute of Ophthalmology from 1st July 2017 to 31st June 2022. Results: Fifty-four cases were included, 18(33.33%) were male and 36 (66.67%) were female. Mean age was 41.47±15.57 years and median age was 38 years. All cases were bilateral. Two patients had a complete presentation (3.7%), thirty an incomplete presentation (55.5%) and twenty-two had a possible syndrome (40.7%). Fortysix (85. 1%) patients presented at acute uveitic stage and eight (14.8%) presented at chronic recurrent stage. The most common extraocular finding in our patient population was headache (59.2%). Posterior segment findings included exudative retinal detachment in 40(74%), disc edema in 33(61.1%) and sunset glow fundus in 3(5.5%). Conclusions: Bilateral panuveitis is the most common ocular manifestation of VKH and majority of eyes present with exudative retinal detachment. Oral prednisone with or without immunomodulatory therapy was the primary treatment. Keywords: Immunomodulatory therapy; Nepal: panuveitis; vogt-koyanagi-harada disease.